Can I die at home please?

Angelika Elliott comforts her husband, Dr John Elliott, as he tries to rise from his hotel room bed a day before he went to the Dignitas clinic to end his life.

It’s a question many of us may ask. Either to a doctor or as a silent plea. Sometimes when I am just poorly with the flu I try to think about it. My choice would probably be self-deliverance. Would I drag myself out of bed to get the helium currently in the Exit office near where I live? Or would I use the compression method without rising from my bed?

The choice is complicated if we are in complex medical care. One is either able and prepared and able to choose to take matters into one’s own hands or not. Many people would just like to have some palliative care support and die at home among friends, family, familiar surroundings.

A recently published study of deaths in six European countries found that the percentage of all cancer deaths occurring at home was 12.8 in Norway, 22.1 in England, 22.7 in Wales, 27.9 in Belgium, 35.8 in Italy, and 45.4 in the Netherlands. Having solid cancers and being married increased the chances of dying at home in all countries. Being older and being a woman decreased the chances of dying at home, except in Italy where the opposite was the case. A higher educational attainment was associated with better chances of dying at home in Belgium, Italy, and Norway (countries where information on educational attainment was available). Better chances of dying at home were also associated with living in less urbanized areas in all countries but England.

Some will find they do not need the detailed self-deliverance techniques they have rehearsed and prepared (but may still take comfort knowing they could use them). For many, palliative care is adequate. For some it is not, and of those some will be better prepared than others.For those that can afford it, Dignitas continues to provide a non-medicalised environment and assistance in dying. As we go to press with this blog, another Brit has just died at the Dignitas suicide clinic in Switzerland – at the age of just 42. Multiple sclerosis sufferer Andrew Colgan spent months arranging his death, even writing his own obituary. He only told his parents Yvonne and Patrick at the last minute to ensure they would not face criminal charges.

We all want to come home to rest. May our readers enjoy a restful end to 2010 – and be able to look froward to 2011 or the years ahead with confidence and reassurance about that final resting when it comes.



Which patients with cancer die at home? A study of six European countries – Journal of Clinical Oncology
Population-based study of dying in hospital in six European countries
– Palliative Medicine (journal article)
Dying at home or in an institution – Health Policy (journal article)
Talking about Dying – general statistics (England) and interesting facts
Assisted suicide statistics: the numbers Dignitas helps to die, by country
Palliative care at the end of life – including symptoms
Andrew Colgan dies at Dignitas (Sun)
Andrew Colgan (Daily Mail)
Andrew Colgan (Telegraph)
Andrew Colgan (This is Staffordshire)
Let me die at home – Montreal campaigner pleads

Talking about DyingTalking about Dying
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